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AIDS Behav. 2016 Sep;20(9):1883-92. doi: 10.1007/s10461-015-1279-4.

Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

Author information

1
Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA. sara.newmann@ucsf.edu.
2
Ibis Reproductive Health, Oakland, CA, USA. sara.newmann@ucsf.edu.
3
Department of Obstetrics, Gynecology & Reproductive Sciences, San Francisco General Hospital, 1001 Potrero Avenue, Unit 6D-14, San Francisco, CA, 94110, USA. sara.newmann@ucsf.edu.
4
Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA.
5
Kenya Medical Research Institute, Nairobi, Kenya.
6
Ibis Reproductive Health, Oakland, CA, USA.

Abstract

This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.

KEYWORDS:

Family planning; Gender equity; HIV; Integrated services; Sub-Saharan Africa

PMID:
26837632
DOI:
10.1007/s10461-015-1279-4
[Indexed for MEDLINE]

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